Prior to the penicillin era most of the reports of vaginitis in children were concerned with the management of gonorrheal vaginitis.1-3 Since then, gonorrhea has practically disappeared and nonspecific bacterial vaginitis has assumed primary importance.
In this preantibiotic period, estrogen was used widely in the treatment of vaginitis in children. The work of Robert Lewis,1 in 1933, pioneered this therapeutic approach. Lewis and others2,4 felt that vaginitis in children was due to an exaggeration of the normal hypoestrogenism of childhood, which in turn produced an atrophy of the vaginal mucosa. Estrogen administration could increase the cellular depth of the vaginal epithelial layer, and this artificially hypertrophied surface acted as a barrier to the invasion of bacteria. Gonorrheal vaginitis was treated therefore with local or systemic estrogens.
In the current reports of preadolescent vaginitis, most authors stress the importance of general health measures, the presence of other infections